Use of aromatase inhibitors in gynecology

Intisar M Elnahhas, M.F. Mitwally
In: Expert Review of Obstetrics & Gynecology · 2010 · vol. 5(2) , pp. 257–265 · doi:10.1586/eog.10.10 · W2116494083
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Aromatase inhibitors effectively induce ovulation and alleviate endometriosis pain, with potential benefits for other gynecological disorders, and risks of hypoestrogenism are manageable with short-term use and hormone replacement.

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Abstract

The third-generation aromatase inhibitor group includes letrozole, and anastrozole and exemestane have both been approved for suppression of estrogen in postmenopausal women with breast cancer. It seems scientifically plausible that various gynecological disorders that are estrogen dependent would benefit from estrogen suppression by aromatase inhibitors. When an aromatase inhibitor is used in premenopausal women, blocking an endogenous rise of gonadotropins by gonadotropin-releasing hormone analogs or sex steroids is mandatory to achieve adequate estrogen suppression. The two most frequently investigated gynecological conditions for the use of aromatase inhibitors include infertility and endometriosis. Available evidence strongly supports the success of aromatase inhibitors for the induction of ovulation, and reducing the pain associated with endometriosis. Preliminary evidence of success in managing other gynecological disorders, such as uterine leiomyomas, exists. Bone loss and dyslipidemia are potential risks caused by hypoestrogenism associated with aromatase inhibitor use. However, those risks seem to be more theoretical than real. The short-term use of aromatase inhibitors and the judicial use of the add-back concept of hormone replacement by estrogen and/or progesterone may minimize those risks.

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Condition tags

endometriosisinfertility

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References (73)

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